Barriers and enablers of physical activity engagement for patients with COPD in primary care.

Maria-Christina Kosteli,Andrew Dickens,Sheila Greenfield,Peymane Adab,Nicola Heneghan,Alexandra Enocson,Sarah Williams,Carolyn Roskell,Rachel Jordan,David Fitzmaurice,Kate Jolly,Jennifer Cumming

doi:10.2147/copd.s119806

Abstract

BackgroundGiven that physical activity (PA) has a positive impact on COPD symptoms and prognosis, this study examined the factors that both encourage and limit participation in PA for individuals with COPD in a primary care setting from the perspective of social cognitive theory.MethodsA purposive sample of 26 individuals with a range of COPD severity (age range: 50–89 years; males =15) were recruited from primary care to participate in one of four focus groups. Thematic analysis was undertaken to identify key concepts related to their self-efficacy beliefs.ResultsSeveral barriers and enablers closely related to self-efficacy beliefs and symptom severity were identified. The main barriers were health related (fatigue, mobility problems, breathing issues caused by the weather), psychological (embarrassment, fear, frustration/disappointment), attitudinal (feeling in control of their condition, PA perception, older age perception), and motivational. The main enabling factors were related to motivation (autonomous or controlled), attitudes, self-regulation, and performance accomplishments.Clinical implicationsWhen designing interventions for individuals with COPD, it is important to understand the patient-specific social cognitive influences on PA participation. This information can then inform individually tailored management planning.

Highlights

COPD is a debilitating respiratory disease most commonly found in chronic smokers,[1] which leads to both physical functional limitations and psychological distress.[2]
Conclusion and themes of study Conclusion: importance of individualized targeted approach Most commonly reported barrier: poor health Further research needed on enabling strategies for participation in physical activity (PA) Limitation: limited generalizability (Continued)
Conclusion: patients with COPD are less active than healthy adults Most commonly reported barriers: lack of infrastructure, lack of willpower, and social influences

Summary

Introduction

COPD is a debilitating respiratory disease most commonly found in chronic smokers,[1] which leads to both physical functional limitations (including increased breathlessness) and psychological distress (including anxiety and depression).[2]. Given that physical activity (PA) has a positive impact on COPD symptoms and prognosis, this study examined the factors that both encourage and limit participation in PA for individuals with COPD in a primary care setting from the perspective of social cognitive theory. Results: Several barriers and enablers closely related to self-efficacy beliefs and symptom severity were identified. Clinical implications: When designing interventions for individuals with COPD, it is important to understand the patient-specific social cognitive influences on PA participation. This information can inform individually tailored management planning.

Results

Discussion

Conclusion